This article covers sample Capstone project topic selection and approval.
In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.
Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:
The problem, issue, suggestion, initiative, or educational need that will be the focus of the project
The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
A proposed solution to the identified project topic
Sample Answer – Capstone project topic selection and approval
My proposed capstone project topic is on the use of antipsychotic medications in older patients with dementia. Dementia has become a matter of public health concern across the world. Recent global estimates indicated that about 48 million people in the world are affected by dementia, a figure that is projected to increase to about 75 million by 2030 and 131.5 million by 2050 (Prince, Ali, Maëlenn, Prina, Albanese & Wu, 2016). Dementia also exerts considerable burden on caregivers, especially when it is associated with behavioral and psychological symptoms, such as aggression and psychosis (Prince et al, 2016). In United States, it is estimated that 5-10% of people aged above 65 years have dementia (APA, 2016). The prevalence of dementia is reported at 30-40% in people aged 85 years and above in the country (APA, 2016).(Capstone project topic selection and approval)
In older population, Alzheimer is a comorbid condition reported in significant number of patients with dementia. Cognitive impairment is the main symptom associated with dementia (APA, 2016). However, a significant proportion of dementia patients report considerable behavioral problems, such as irritability, agitation, aggression psychosis, delusions and other neuropsychiatric symptoms (Wimo & Jonsson, 2013). Patients suffering from these symptoms could inflict injuries on self and other persons. However, the occurrence of the behavioral and psychological symptoms associated with dementia varies greatly depending on the medical setting and the severity of the condition (APA, 2016).(Capstone project topic selection and approval)
Various empirical studies estimated the prevalence of delusions at 18-25 % and aggression at 9-30% among the patients with dementia under investigation (Prince, et al, 2016; Banerjee, 2014). Similarly, several research studies have indicated psychosis to be a major symptom in patients with dementia (APA, 2016; Zahirovic, Torisson, Carina, & Londos, 2018). Aggression and psychosis are some of the common symptoms reported in older patients with dementia (APA, 2016). The severity of the symptoms increases with the progression of dementia and exacerbation of cognitive impairment. Additionally, the symptoms are persistent and chronic (APA, 2016). Empirical studies indicate varying prevalence of the symptoms across different clinical settings. Older patients with dementia in nursing homes and in inpatient care settings report a higher prevalence of aggression and psychosis than those in community settings (Zahirovic, Torisson, Carina, & Londos, 2018).(Capstone project topic selection and approval)
Currently, no effective treatment for the condition has been developed yet. However, significant resources have been invested in dementia research, especially on the neurological characteristics, pathophysiology, the causes and effects of various pharmacological interventions. Antipsychotic drugs are normally used to treat the various symptoms associated with dementia, such as psychosis and aggression. The commonly used antipsychotic drugs are classified into two categories namely typical and atypical antipsychotics (Zahirovic, Torisson, Carina, & Londos, 2018).(Capstone project topic selection and approval)
Antipsychotics induce undesirable health effects to pateints, such as depressed mood, low blood pressure, rapid heart rate, stroke, and acute cardiovascular events, which are associated with increased morbidity and mortality among elderly patients with dementia (APA, 2016). Empirical studies indicate that use of antipsychotics is associated with increased mortality rates due to the various side effects associated with their use (Zahirovic, Torisson, Carina, & Londos, 2018; Wimo & Jonsson, 2013). Additionally, the use of antipsychotics is associated with increased hospital stay, increased cost of healthcare and low quality of life in patients suffering from the adverse side effects (Banerjee, 2014; APA, 2016).(Capstone project topic selection and approval)
Non pharmacological interventions are recommended as the first line of treating various symptoms associated with dementia and antipsychotics should be used as the last resort (Zahirovic, Torisson, Carina, & Londos, 2018). However, prescription of antipsychotics is common in various clinical settings, which undermine the treatment outcomes of the patients. Studies indicate high levels of unnecessary antipsychotic prescription among elderly population with dementia in various clinical settings. A study conducted by Prince, et al (2016) found 30% of the total patient population in nursing homes receiving antipsychotic medications(Capstone project topic selection and approval)
This study proposes empowering home based caregivers with relevant skills to enable them address the various behavioral and psychiatric symptoms presented in elderly patients with dementia in outpatient care settings. The main approach of empowering the home-based care givers is education. Educating the home based caregivers in the outpatient setting is of significance to nursing practice because it would minimize the use of antipsychotic medications and the adverse health outcomes associated with their use in elderly patients with dementia. Additionally, it would help in reducing the cost of healthcare and enhance the quality of life among elderly patients with dementia.(Capstone project topic selection and approval)
American Psychiatric Association (APA). (2017). The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. New York: Author.(Capstone project topic selection and approval)
Banerjee, S.(2014). The use of antipsychotic medication for people with dementia: Time for action. London: Department of Health, United Kingdom, available at https://www.rcpsych.ac.uk/pdf/Antipsychotic%20Bannerjee%20Report.pdf
Prince, M., Ali, G., Maëlenn , G., Prina, M., Albanese, E., & Wu, Y.(2016). Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimer’s Research & Therapy, 8(23):2-13.(Capstone project topic selection and approval)
Wimo, A., & Jonsson, L.(2013). The worldwide economic impact of dementia 2010. Alzheimer’s Dementia, 9(1):1–11.
Zahirovic, I., Torisson, G., Carina, W., & Londos, E.(2018). Psychotropic and anti-dementia treatment in elderly persons with clinical signs of dementia with Lewy bodies: a crosssectional study in 40 nursing homes in Sweden. BMC Geriatrics, 18(50): 2-9(Capstone project topic selection and approval)